My student; my teacher

One of my erstwhile students and currently a good friend, taught me a wonderful lesson today. I had just wound up my routine Sunday clinic and was traveling home. “How are you Ayya?” he had texted me and we were having a text conversation. This young man has always referred to me as “Ayya” which is a beautiful word in Tamil which means many things including teacher, father, grandfather, God, Master to just name a few, basically anybody who is a respectable older male. I think he first started calling me “Ayya” implying teacher, but probably it evolved to mean father. I have a very paternal feeling to this young man, and he probably reciprocates it! Our discussion started moving towards medical practice. One of my deepest concerns has been that I am not able to practice cutting edge evidence-based medicine in my clinic as it is grossly resource deprived and the people attending the clinic are extremely poor. I was expressing this concern to him and lamenting. I was taking it to the extreme and telling him that I feel like a ‘quack with an MD”. Thinking back now, it was very unfair to burden him with all my uncertainties. 

 

“I saw a young 35-year-old man with diabetes. This man had premature ejaculation and was in extreme distress. I did not have the resources to evaluate him, and he did not have the time to visit the nearest tertiary care center, 50 Km away, for a detailed evaluation. I just reassured him and taught him some techniques to try and delay ejaculation. I think I did not do enough for this poor young man, who could be suffering from something more serious…” I was lamenting to my friend. He was giving me all the appropriate responses. He was telling me “What more could you have done Ayya?” But it was not enough for me as my looming uncertainty and self-pity was not allowing me to see the situation clearly. The conversation moved from there to some greater degree of self-pity, where I told him that I had such wonderful teachers like Dr. Misra and though he would never be disappointed with me, I hadn’t done anything to make him proud. 

 

He was listening to me patiently and in a very stoic manner, he was responding with mild and appropriate texts. Then suddenly he sent me a picture of himself with a beautiful girl child held in his arms. He was in the centre of the photo resplendent in a red patterned kurta. He was holding a beautiful chubby girl baby in his arms close to his chest. The baby was nestling so snugly in his arms. He was looking down at her with so much love in his eyes. Every part of his face was ablaze with a brilliant bright smile. His eyes, forehead, cheeks, nose, mouth, everything was smiling. The photo had captured a very rare moment. I think one needs to be a pediatrician (children's doctor) to understand the feeling. A few weeks ago, this child was sick, and he was holding the child in his arms trying desperately to bring it to good health. Now the child was home and with her parents, healthy and moving ahead towards a wonderful future. That happiness of playing a small role in handing the baby back to her parents, the world and to the future, must be a divine sensation. That happiness was what I saw in my friend’s face. Suddenly the tone and tenor of the chat changed. I asked him about the photo. He said, “Ayya, this child was very sick, and I cared for her. Now she is back in her parent’s arms and children always look so much cuter in their parents’ arms. They had invited me over to their home and I was visiting”. I felt a sudden gush of warmth and love wash over me. 

 

I remembered what had happened after I spoke to that 35-year-old man about whom I had mentioned earlier. After our almost 20-minute conversation, in which I didn’t do much other than listen to him respectfully, talk to him and gave him some simple suggestions to improve things, he got up and left and told me “Thanks Anna”. Anna is another beautiful Tamil word which means elder brother. It is not often that patients have called me Anna. Anna is such a personal word and when a patient calls you Anna, to me it means the barrier is broken and the patient and I have become close friends, a trusting relationship has been established. I suddenly remembered that, and the anguish of not being able to do much to help him other than talking to him, morphed into this very warm feeling of satisfaction of having established a good relationship with a fellow human being. 

 

In quick succession I also remembered the elderly lady with very poor vision ridden by a dense cataract which she is unable to get operated as she has nobody to take care of her, who hugged me and kissed my forehead. I also remembered the stone quarry manager who came to see me and slipped in a bag of ripe bananas under my table from his garden. I suddenly felt so happy and satisfied. My erstwhile student, my current friend, the pediatrician in making, had now become my teacher. He helped me see that medicine is not just tests, drugs, injections, surgeries, and procedures. Medicine is a very mushy human art. Often times, all that needs to be done is just being there to listen to the patient and support them when their morale drops. Every ‘thanks Anna”, every kiss on the forehead and gift of bananas is a mark of how much just being there to listen, support and lend a broad, warm shoulder to cry on means to the patient. 

 

As I reached home, I realized that my student / friend / teacher had just helped me see that being a doctor is far more than learning and practicing medicine. Being a doctor is being a friend, and a support system. I am eternally grateful for my profession, which not only gives me such human interactions each day, but also puts me in touch with students who grow to become my teachers!